The short answer is to keep the diabetic control tight enough to have the hemoglobin A1C in the low 5's or under 5%.
If there is already compromise of the arterial circulation of the legs to address that systematically & regionally. If there are already ulcers need aggressive regional care. If there is already bone infection, it's more a matter of chronic management, but not impossible to cure. And get professional toenail care, wash feet & keep well lubricated daily, and never ever go barefoot or in stocking feet. Always wear shoes that are protective. Inspect feet daily for any breaks in the skin; even a small crack can lead to loss of limb. If there is any tinea pedis ('athlete's feet') must treat, as eventually leads to microbes in the skin which give the bacteria a port of entry.
Lastly, Indians genetically have a high penetrance of dyslipidemia (cholesterol problems) & need a treat that very aggressively (in order to prevent hardening of the arteries of the legs); the most aggressive doctors treat it to get the "non-HDL" at about 100, and the "LDL" at about 70. (the non-HDL is the total cholesterol minus the HDL, & is a proxy marker for the agressive sub-fractions of the LDL). There was a study a few years ago in Lancet on Indians & had statistically smaller coronary arteries; can debate the why of that, but to me it means the most aggressive standards of a care needs be applied to any diabetic Indian.
And no smoking, ever!!



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